Medication-related osteonecrosis of the jaw (MRONJ) is a serious adverse reaction of antiresorptive and antiangiogenic agents, and it is also a potentially painful and debilitating condition. To date, no specific studies have prospectively evaluated the efficacy of its treatment and no robust standard of care has been established. Therefore, a systematic review (2007–2020) with a pooled analysis was performed in order to compare MRONJ surgical techniques (conservative or aggressive) versus combined surgical procedures (surgery plus a non-invasive procedure), where 1137 patients were included in the pooled analysis. A statistically significant difference in the 6-month improvement rate, comparing combined conservative surgery versus only aggressive (91% versus 72%, p = 0.05), was observed. No significant difference regarding any group with respect to the 6-month total resolution rate (82% versus 72%) was demonstrated. Of note, conservative surgery combined with various, adjuvant, non-invasive procedures (ozone, LLLT or blood component + Nd:YAG) was found to achieve partial or full healing in all stages, with improved results and the amelioration of many variables. In conclusion, specific adjuvant treatments associated with minimally conservative surgery can be considered effective and safe in the treatment of MRONJ, although well-controlled studies are a requisite in arriving at definitive statements

Dysbiosis has been associated with the onset of several chronic autoimmune or inflammatory pathologies (e.g., inflammatory bowel diseases—IBD), because of its primary role in the establishment of a chronic inflammatory process leading to tissue damage. Inflammatory bowel diseases can even involve areas far away from the gut, such as the extraintestinal manifestations involving the oral cavity with the onset of aphthous-like ulcers (ALU). Studies carried out on animal models have shown that intestinal dysbiosis may be related to the development of autoimmune diseases, even if the mechanisms involved are not yet well known. The aim of this paper is to verify the hypothesis that in inflammatory bowel diseases patients, aphthous-like ulcers are the result of the concomitance of intestinal dysbiosis and other events, e.g., the microtraumas, occurring in the oral mucosa, and that ex adiuvantibus therapy with probiotics can be employed to modify the natural course of the aphthous-like ulcers.

Introduction: Oral mucositis (OM) is a major side effect of cancer therapy, which is associated with significant symptoms, treatment delays and increased costs for the health system. It is an important component of the quality of life of cancer patients and, until now, there has been no gold standard regarding prevention or treatment of this pathology. Notwithstanding the paucity of treatment guidelines (due to limited evidence from high-quality, rigorous studies), sodium bicarbonate (SB) rinses are one of the most used agents for OM management. Objectives: A systematic review (2000–2022) was performed in order to compare and examine different agents versus sodium bicarbonate (SB) in preventing or treating OM. Sources: Eleven randomized controlled trials (RCT) were evaluated: four were conducted for the prevention and seven for the management of OM. The risk of bias of RCTs was assessed using the revised Cochrane risk of bias tool for randomized trials. Study selection: According to the RoB2 evaluation for randomized trials, four RCTs were judged to be at a high risk of bias, two were rated as ‘problematic’, while five were deemed to be a low risk of bias. Conclusions: The results revealed that there was no evidence for supporting SB in OM treatment regarding management and prevention. Clinical significance: Results showed in this review takes on a strategic importance in the use of SB for OM management or prevention; indiscriminate use of SB could be counterproductive because it causes a sudden pH increase and it delays proper OM pharmacological treatment.

Background: Transverse maxillary discrepancies during mixed dentition can negatively affect occlusal development and facial harmony. Clear aligners have been increasingly proposed as an interceptive alternative to traditional expansion approaches, but the extent and nature of the transverse dentoalveolar changes associated with their use in growing patients remain incompletely defined. While previous reviews have qualitatively explored this topic, no prior meta-analysis has been conducted to provide a quantitative synthesis of these changes in mixed dentition. Methods: A comprehensive electronic search was conducted for English-language studies published from January 2019 to April 2026 using the PubMed, Ovid MEDLINE, Web of Science, Embase, and Cochrane Library databases. The final database search was performed on 30 April 2026. Randomized controlled trials, prospective studies, and retrospective studies evaluating transverse maxillary changes in growing patients treated with clear aligners were included. Case reports, reviews, and studies involving syndromic patients or surgical interventions were excluded. Two reviewers independently performed study selection, data extraction, and risk-of-bias assessment. Furthermore, a meta-analysis of quantitative outcomes with sufficient comparability across studies was performed. Effect sizes were reported as standardized mean differences (SMDs). Results: From 40 screened records, a total of 7 studies were included in this review. The meta-analysis revealed a reasonably consistent trend toward increased transverse dimensions. The pooled SMDs were 0.685 (distal intermolar), 1.141 (mesial intermolar), 0.828 (transpalatal), 2.052 (intercanine transpalatal), and 1.541 (intercanine width). However, the magnitude of the effect remains uncertain because of the small number of included studies, methodological variability, heterogeneous outcome definitions, limited long-term follow-up, and substantial statistical heterogeneity observed for selected outcomes. Conclusions: The current evidence base reveals a reasonably consistent direction toward favorable transverse dentoalveolar changes with clear aligner therapy. However, the exact magnitude of the benefit remains uncertain due to methodological heterogeneity and the lack of robust long-term data. Due to the qualitative limitations of the included studies, the meta-analysis was intended to provide exploratory insights rather than definitive conclusions. Further high-quality studies with 3D imaging, standardized 3D outcomes, and long-term follow-up are needed to corroborate these results and guide clinical protocols.

Aim. Cemento-ossifying fibromas (COF) are fibro-osseous lesions, a heterogeneous group of rare and benign lesions of unknown etiology affecting the jaws and other craniofacial bones. COF are characterized by the replacement of normal bone by fibrous tissue, which contains a newly formed, mineralized product. They are included in the group of mesodermal odontogenic tumors; they are seen more commonly in women (5:1) between the third and fourth decades of life and the most common location is in premolar-molar region of the mandible. In the 2017 World Health Organization classification of odontogenic lesions, the term COF was added in order to to separate it from the clinicopathologic entities of the juvenile ossifying fibromas (more aggressive). Clinically, these tumours manifest as a slow-growing intra-bony asymptomatic mass, over a period of time lesion may become large enough to cause facial asymmetry. Radiologically, cemento-ossifying fibroma shows a number of patterns depending on the degree of maturation of the lesion. Histologically, these tumours are composed of well vascularized fibrocellular tissue with the capacity to form immature bone trabeculae and cementoid formations, though these findings are not specific of the lesion and can also be seen in fibrous dysplasia. A definitive diagnosis therefore requires correlation of the clinical, radiological and histological findings. The aim of this paper is to report a case of COF showing radiological and anatomic features of these tumors. Materials and Methods. A 18-year-old female patient, with no relevant medical history, reported to our sector of Oral Medicine (University Hospital “Policlinico Paolo Giaccone” Palermo, Italy) with a chief complaint of slow-growing gum swelling in the lower right back retromolar region for two years. She gave history of pain on chewing food not associated with any discharge, trauma or paresthesia. On extra-oral examination and palpation nothing was noted. On intraoral examination, a single, round, elevated nodule, non-ulcerated, sessile, with some white spots and localized in the center of the alveolar crest, distally to the 47 was seen (48 was not erupted). Tooth 47 tested positive to pulp test. Panoramic x-ray and Intra-Oral Periapical Radiograph of the area showed a well-defined radiopaque lesion above the alveolar crest of the unerupted 48 and intrabony, along the mesial root of 48 with radiopaque scalloped border. Computerized tomography confirmed the previous radiographic finding. After obtaining consent from the patient, surgical enucleation of the lesion on the alveolar crest with curettage of the bone lesion was done under local anesthesia with a piezosurgery device. Results. Histological examination revealed a fibrous connective tissue with an increase in cells growth characterized by some areas of mature bone tissue and basophilic calcific areas. Cellular component was composed of fibroblast arranged in different patterns. Calcified area appeared to be composed of cementum like material. There were no atypias or mitotic figures. Patient came back for stiches removal and we noticed the complete healing of the mucosa. Up to date, the patient is under follow up. A new follow up panoramic x-ray was prescribed for the six-month follow-up appointment. Discussion. COF has always been surrounded by controversy regarding the terminology and criteria of diagnosis because it is derived from the mesenchymal blast cells of the periodontal ligament, and has a potential to form fibrous tissue, cement and bone or a combination of such elements. In the decades since the conception of the terminology COF, much has changed regarding our understanding, imaging, histopathological categorization and treatment strategies of the various fibro-osseous lesions. The diagnosis of COF of the jaw can be established based on both clinical, radiographic and histo-pathological features. Complete surgical removal of the lesion at the earliest possible stage is advised because average recurrence rate of COF is reported between 10.1% and 28%, with an average follow-up of 38 months. Hence an average follow-up period of 10-years is advocated.